Individual
DR. STACY MARIE CHRONISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
717 S HOUSTON AVE STE 304, TULSA, OK 74127-9023
(918) 382-5064
(918) 382-3589
Mailing address
717 S HOUSTON AVE STE 304, TULSA, OK 74127-9023
(918) 382-5064
(918) 382-3589
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4888
OK
207R00000X
Internal Medicine Physician
P1629
TX
207RB0002X
Obesity Medicine (Internal Medicine) Physician
4888
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200612290B
—
OK
Enumeration date
06/25/2008
Last updated
10/21/2019
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